Pancreatitis and post‐pancreatitis diabetes in Central Australia

Pancreatitis and post‐pancreatitis diabetes in Central Australia

Background Pancreatitis and diabetes are common among Aboriginal people of Central Australia. The contribution of pancreatitis to the development of post‐pancreatitis diabetes mellitus (PPDM) is not known. Aims To describe among Aboriginal and non‐Aboriginal people living in Central Australia, (i) t...

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Published in:Internal medicine journal Vol. 53; no. 4; pp. 568 - 576
Main Authors: Wicks, Mary M., Barr, Elizabeth L. M., Maple‐Brown, Louise
Format: Journal Article
Language:English
Published: Melbourne John Wiley & Sons Australia, Ltd 01-04-2023
Wiley Subscription Services, Inc
Subjects:
Australia - epidemiology
Diabetes
Diabetes mellitus
Diabetes Mellitus - epidemiology
Diagnosis
Etiology
exocrine pancreas
Female
Health Services
Humans
indigenous health
Male
Native peoples
Northern Territory
Pancreatitis
Pancreatitis - diagnosis
Pancreatitis - epidemiology
Patients
Retrospective Studies
Australia
exocrine pancreas
pancreatitis
Northern Territory
diabetes
indigenous health
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Summary:Background Pancreatitis and diabetes are common among Aboriginal people of Central Australia. The contribution of pancreatitis to the development of post‐pancreatitis diabetes mellitus (PPDM) is not known. Aims To describe among Aboriginal and non‐Aboriginal people living in Central Australia, (i) the prevalence and aetiology of acute (AP) and chronic pancreatitis (CP), and (ii) diagnosis of new onset diabetes after pancreatitis. Methods Retrospective medical record review of patients ≥15 years admitted to hospitals in the Central Australia Health Service between 2009 and 2018 with pancreatitis. Prevalence as a proportion of the resident population and aetiology of AP and CP were determined. Diagnosis of new onset diabetes after admission with pancreatitis was assessed. Results Of the 638 patients assessed, 73% were Aboriginal and 48% female. The annual prevalence in 2009 and 2018 for AP was 171 and 203 per 100 000 persons, and for CP was 206 and 114 per 100 000 persons respectively. Rates were high in Aboriginal people. Alcohol aetiology was most common in Aboriginal people (66%) and biliary aetiology in non‐Aboriginal people (37%). A diagnosis of diabetes after pancreatitis was detected in 125 (29%) of 438 patients who did not have a diabetes diagnosis previously recorded, and 20 of the 22 tested for diabetes‐associated antibodies were negative, fitting criteria for PPDM. Conclusion Prevalence of AP and CP in Central Australia was higher in Aboriginal than non‐Aboriginal people. Few patients with diabetes recorded after pancreatitis had appropriate PPDM diagnostic testing. Interdisciplinary education on the diagnosis of PPDM is required.
Bibliography:Note on terminology: The First Nations people of Central Australia refer to themselves as Aboriginal people and this terminology will be used in this paper.
Funding: M. Wicks is in receipt of a NHMRC Postgraduate Scholarship Stipend (#1191416). L. Maple‐Brown is funded by a NHMRC Investigator Grant (#1156726).
Conflict of interest: None.
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ISSN:1444-0903
1445-5994
DOI:10.1111/imj.15620